^(18)F-FDG与^(68)Ga-DOTATATE全身PET/CT显像在神经内分泌肿瘤中的价值  

Value of ^(18)F-FDG and ^(68)Ga-DOTATATE total-body PET/CT imaging in patients with neuroendocrine neoplasms

作　　者：林禹 高华萍 石洪成 Lin Yu;Gao Huaping;Shi Hongcheng(Department of Nuclear Medicine,Zhongshan Hospital,Fudan University,Shanghai Institution of Medical Imaging,Nuclear Medicine Institute of Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院核医学科、上海市影像医学研究所、复旦大学核医学研究所,上海200032

出　　处：《中华核医学与分子影像杂志》2023年第11期644-648,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：上海市临床重点专科项目(shslczdzk03401)。

摘　　要：目的探讨^(68)Ga-1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸-D-苯丙氨酸1-酪氨酸3-苏氨酸8-奥曲肽(DOTATATE)联合^(18)F-FDG全身PET/CT显像在神经内分泌肿瘤(NEN)原发灶诊断及肿瘤异质性评价中的价值。方法回顾性分析2020年8月至2023年3月在复旦大学附属中山医院行1/10活度^(18)F-FDG和1/2活度^(68)Ga-DOTATATE全身PET/CT显像的39例具有病理诊断患者的临床、影像及病理资料[NEN 30例,非NEN 9例;男18例,女21例;年龄(54.0±11.4)岁]。将NEN原发灶分为神经内分泌瘤(NET)G1、G2、G3及神经内分泌癌(NEC)。分析双显像剂全身PET/CT显像互补结合对NEN原发灶的诊断效能及对肿瘤异质性评价的价值。结果^(68)Ga-DOTATATE单独及联合^(18)F-FDG全身PET/CT诊断NEN原发灶的灵敏度、特异性、准确性分别为81.2%(26/32)、7/9、80.5%(33/41)和90.6%(29/32)、7/9、87.8%(36/41)。有10个NET G1和7个NET G2病灶有^(68)Ga-DOTATATE摄取,无^(18)F-FDG摄取;有2个NET G2病灶没有^(68)Ga-DOTATATE摄取,但有^(18)F-FDG摄取;2个NET G1及6个NET G2病灶同时具有^(68)Ga-DOTATATE和^(18)F-FDG摄取。患者接受的^(68)Ga-DOTATATE、^(18)F-FDG和1次检查CT的辐射剂量分别为(1.59±0.50)、0.49(0.44,0.58)和11.46(10.53,12.85)mSv。结论双显像剂全身PET/CT显像互补结合对NEN原发灶具有较高的诊断效能,可充分评估肿瘤间的异质性。Objective To investigate the value of ^(68)Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide(DOTATATE)combined with ^(18)F-FDG total-body PET/CT imaging in the diagnosis and heterogeneity assessment of primary foci of neuroendocrine neoplasms(NEN).Methods Clinical,imaging and pathological data of 39 patients with pathological diagnosis(30 NEN and 9 non-NEN,18 males and 21 females,age(54.0±11.4)years)who underwent 1/10 activity ^(18)F-FDG and 1/2 activity ^(68)Ga-DOTATATE total-body PET/CT combined imaging in Zhongshan Hospital,Fudan University from August 2020 to March 2023 were retrospectively analyzed.The NEN primary foci were classified as neuroendocrine tumor(NET)G1,G2,G3,and neuroendocrine carcinoma(NEC).Diagnostic efficacy of combined dual-low activity dual-tracer imaging for NEN primary foci and its value for evaluating tumor heterogeneity were analyzed.Results The sensitivities,specificities,and accuracies of ^(68)Ga-DOTATATE alone and in combination with ^(18)F-FDG total-body PET/CT for the diagnosis of NEN primary foci were 81.2%(26/32),7/9,80.5%(33/41)and 90.6%(29/32),7/9,87.8%(36/41),respectively.Ten NET G1 and seven NET G2 lesions showed ^(68)Ga-DOTATATE uptake and no ^(18)F-FDG uptake;two NET G2 lesions showed no ^(68)Ga-DOTATATE uptake but ^(18)F-FDG uptake;and two NET G1 and six NET G2 lesions showed both ^(68)Ga-DOTATATE and ^(18)F-FDG uptake.The radiation doses of ^(68)Ga-DOTATATE,^(18)F-FDG and a single examination of CT were(1.59±0.50),0.49(0.44,0.58)and 11.46(10.53,12.85)mSv,respectively.Conclusion Combining total-body PET/CT imaging with dual tracers can effectively diagnose NEN primary foci and assess inter-tumor heterogeneity.

关 键 词：神经内分泌瘤 受体 肽 有机金属化合物 镓放射性同位素 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R739.4[医药卫生—肿瘤]